A majority of the research in patients with chronic ischemic heart disease and left ventricular dysfunction deals with increasing patient survival rates and years. Very little research has focused on patients' perceptions of living with this chronic debilitating disease. The purpose of this study is to assess the Health Related Quality of Life (HRQOL), anginal symptoms and symptom distress experienced by patients with chronic ischemic heart disease and left ventricular dysfunction. The relationship between underlying cardiac condition, anginal symptoms, symptom distress and HRQOL will be examined. The trend in HRQOL across time versus treatment group (medical or surgical management) will be evaluated. Patients respond to questionnaires that measure HRQOL, anginal symptoms and symptom distress. Underlying cardiac condition will be assessed using exercise thallium imaging parameters and positron emission tomography(PET)imaging parameter (viability). Questionnaires are administered at three time intervals over a 1-year period. Data will be analyzed using multivariate techniques. Twenty-five subjects have been accrued to date. Data collection continues.